Provider Demographics
NPI:1427568773
Name:BLOM, MORIHA LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MORIHA
Middle Name:LYNN
Last Name:BLOM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W CHESTNUT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4631
Mailing Address - Country:US
Mailing Address - Phone:724-223-7710
Mailing Address - Fax:724-223-7712
Practice Address - Street 1:1100 W CHESTNUT ST STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4631
Practice Address - Country:US
Practice Address - Phone:724-223-7710
Practice Address - Fax:724-223-7712
Is Sole Proprietor?:No
Enumeration Date:2017-10-01
Last Update Date:2017-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP046348183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist